Physicians devote our lives to serving others. We endure a rite of passage known to rare few. We work undeterred for the good of each individual patient, together in trust, making many personal sacrifices by choice. I have utmost respect for my colleagues, unified in the Hippocratic Oath, equipped with hard-earned knowledge, skills, wisdom, and experience to do what was once unfathomable- until now.
External philosophical and political forces are preying on our intrinsic enduring calling to serve others. These forces intentionally manipulate, extort, and oppress us as a means to achieve fundamental transformation of the United States of America. These forces are succeeding using predictable tactics including creating crisis and dividing us into groups, one against another and against ourselves. We are told the quality of medicine we are providing is bad, that we are bad, and that government must fix our patients, our profession, and us. I call B.S.
We have been lied about, lied to, denigrated, and subjected to abusive measures resulting in a growing phenomenon that could rightly be called Battered Physician Syndrome. This syndrome is deadly for physicians, patients, the profession of medicine, and individual liberty. It is the physician’s responsibility to recognize and develop resistance to this syndrome.
Battered Spouse Syndrome is defined as “A pattern of signs and symptoms, such as fear and a perceived inability to escape, appearing in those who are physically and mentally abused over an extended period by a spouse or dominant individual.”
Battered Physician Syndrome could be defined similarly as “A pattern of signs and symptoms such as fear and a perceived inability to escape, appearing in doctors who are physically and mentally abused over an extended period of time by demands and constraints of their profession or dominant individuals and groups seeking to malign and control them.”
Under the expanding umbrella of government-run medicine in an entrenched entitlement state, physicians are barraged with constant undeserved defamation and increasingly impossible physical, regulatory, and financial demands. Verbal and nonverbal threats of physical, financial, legal, and professional harm, if not ruin, are constantly unleashed on us from the Administrative Branch of the Federal government via the Department of Health and Human Service’s CMS, the Treasury’s IRS, the D.O.J., and more. Groups like the AMA, our specialty societies, big hospital, big pharma, big insurance, IT, and other special interests emboldened and enabled by a biased, weak press aid and abet the annihilation of American medicine. The constant mistreatment causes physicians to increasingly complain of symptoms consistent with chronic physical and emotional abuse. I see this in my physician patients, my physician friends, and my physician family members. I see this in myself. Physicians show signs of physical assault including overt manifestations of sleep deprivation, malnourishment, and lack of exercise. Many suffer with actual physical disease such as cancer, high blood pressure, and stress related conditions. Signs of depression are common. Physician burnout and a stunning physician suicide rate are only recently acknowledged by our peers.
In spite of this, many physicians continue to comply with the oppressors’ usurious demands, whether it be from fear of losing our certification, licensure, patients, income, or right to practice our trade at all or from the feeling of being trapped with no other way out to care for our patients and provide for our families. Other physicians are leaving the profession, and worse, they are discouraging the best and brightest from pursuing a career in medicine.
April 16th Obama signed H.R.2, known as the “DocFix,” into law. This law further deconstructs the private practice of medicine and destroys physicians’ autonomy to practice patient-centered medicine. Government bureaucrats and committees will call the shots for Medicare patients. The law actually creates Alternative Payment Models (APMs) and a Merit-based Incentive Payment System (MIPS) which require physicians to follow a government rubric on which we will be graded in grade school fashion. Physicians, now defined as “eligible providers”, will get grades from 0-100 as determined by the Secretary of Health and Human Services. The grade for doing what the Secretary prescribes is called the Composite Performance Score. The score is publically posted on the Physician Compare Internet Website of CMS, and the Secretary of HHS assigns each physician a payment adjustment factor based on this score. The payment adjustment factor will be positive, 0, or negative. Based on how well a doctor “performs” for the Secretary, the pay could be adjusted 9% up or 9% down, meaning the Secretary’s most compliant doctors will be paid 18% more than those who don’t perfectly make her wishes our commands. What will doctors put up with, and what will we do or not do for patients in order to be paid 18% more than those government deems “less quality” doctors and to avoid public humiliation on the government website? This is indeed chronic and continued abuse taken too a higher, institutionalized level.
That Battered Physician Syndrome shares features with Battered Spouse Syndrome begs the question- is the propagation of this phenomenon in medicine related to the growing number of women in medicine? Are we more likely to submit to authoritarian domination thus allowing it to proliferate unrestrained in a dark, deafening silence until it’s too late?
Just as many spouses stay in the abusive marriage, will doctors stay in this abusive relationship? We must end this cycle before it ends us. We should apply lessons learned from battered spouses to battered physicians. Physicians must move beyond the stages of denial and guilt to enlightenment and responsibility. This abuse is happening. We are not bad, and we do not deserve this. We must make a choice; we can stay forever trapped in this dysfunctional system enabling and feeding it, or we can say “no more” and get out. It is not easy. We will have to forge a new path and start over from scratch, but we can do it right this time for the good of our patients, our profession, our nation, and our souls. They can take away everything, but our minds and hearts they cannot steal. Our skills, knowledge, experience, and code of ethics they cannot take away. They do not possess what they peddle to our patients. We must opt out of government run medicine. It is time to take responsibility. It’s our choice. Make it.